Cigarette smoking has long been recognized as the most significant preventable cause of morbidity and mortality in the United States. Approximately 80% of current adult smokers began using cigarettes as adolescents. Because of the addictive nature of tobacco, prevention of smoking initiation is critical for individual and public health. Early intervention to prevent tobacco use is especially important in girls who are more likely than boys to be influenced by modifiable risk factors such as peer pressure, perceived social norms, negative affect, and low self-esteem. The purpose of this Phase II proposal is to produce an interactive video game to encourage girls to make sound and informed decisions concerning smoking, and thereby prevent initiation of smoking and subsequent nicotine addiction. Serious games employing interactive computer technology are uniquely suited to the delivery of smoking prevention education because information can be presented in an innovative, engaging manner that is familiar to children and adolescents. In Phase I, an executable prototype was developed and successfully tested for usability, satisfaction, and potential impact on knowledge and attitudes towards tobacco. The specific aims of this Phase II study are to: (1) produce a fully operational video game targeted to girls age 8-12 based on Phase I prototype and design document;(2) assess usability of the final game product;(3) evaluate the impact of game on anti-smoking knowledge, attitudes, and beliefs;(4) evaluate user satisfaction with the game. A multi-site field test of the game will be conducted in collaboration with a national nonprofit organization (Girls, Incorporated) serving girls across the US. Widespread distribution of the game, through traditional retail markets and education distribution channel is anticipated in Phase III. The video game market for girls is relatively untapped. A product targeted specifically to entertain girls, while providing a positive health message in a responsible social environment, has significant commercial value. PUBLIC HEALTH RELEVANCE: The purpose of this Phase II project is to produce an anti-smoking video game targeted specifically to young girls. The primary outcome of this project will be the development of an effective tool for teaching girls about dangers of smoking while engaging in a safe, fun activity. By playing the game, young girls will discover that they have the power to become stronger, healthier women by remaining smoke-free.